This presentation will provide an overview of the policy and treatment issues surrounding involuntary outpatient civil commitment. As such it will explore the current political landscape, discuss alternatives and offer suggestions for protecting the civil rights of persons living with mental illness through the use of advance directives.
The cornerstone of the de-institutionalization movement for those with mental illness was the promise of a new life in the community. It has never been realized. Involuntary outpatient commitment fails to address the fundamental lack of community supports such as housing, medical care, access to appropriate medications, employment training and other services that enable people with mental illnesses to lead full and productive lives in the community.
Of the five million adults who experience severe mental illness, nearly half receive absolutely no mental health treatment. Of those who do receive care, many receive services that are inadequate or inappropriate. Involuntary outpatient commitment appears to increase the use of services because it forces the mental health system to make those services available.
By allowing consumers to use advance directives, policy-makers can help assure that mental health services are as effective as possible, and that consumers are involved in decisions about their treatment. Advance directives can be found in both the mental health and physical health context. Only a few states exclude psychiatric healthcare from their generic advance directive statutes, and those that do often have laws that specifically address advance directives in the mental health context.
See www.nmha.org
Learning Objectives: 1. Assess the status of community-based mental health services. 2. Identify at least two evidence-based alternatives to coercive treatment. 3.Describe the proper role of advance directives in building a responsive mental health system.
Keywords: Access to Care, Mental Health System
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.